Managing multimorbidity in severe asthma: comparison of resources and perspectives between severe asthma specialists and general respiratory physicians across Europe.
Dace Matīsa, Aruna T Bansal, Saša Rink, Anna Freeman, Betty Frankemölle, Mehar Singh, Jacob K Sont, Apostolos Bossios, Ben Ainsworth, Michael Hyland, Rekha Chaudhuri, Florin Mihaltan, Antonio Spanevello, Enrico Heffler, Ian Adcock, Martina Zappa, Giorgio Walter Canonica, Guy Brusselle, Arnaud Bourdin, Giulia Anna Maria Luigia Costanzo, Ildiko Horvath, Dóra Lúðvíksdóttir, Stefania Principe, Peter Kopač, Cláudia Chaves Loureiro, Arne Egesten, Stephanie Korn, Konstantinos Samitas, Marcus Butler, Joerg Leuppi, Edin Jusufovic, Felix Wantke, Shane Hanon, Fabienne Jaun, Virginija Kalinauskaite-Zukauske, Sanja Dimic-Janjic, Graham Roberts, Sanja Hromis, Branislava Milenkovic, Judit Varkonyi-Sepp, Ozlem Goksel, Ana Margarida Pereira, Ratko Djukanovic, Angela Rizzi, Marco Caminati, Ruihua Hou, Anamarija Štajduhar, Dóra Paróczai, Luisa Brussino, Liam G Heaney, Hans Michael Haitchi, Matteo Bonnini, Kristina Bieksiene, Ebru Damadoglu, Valentyna Yasinska, Bilun Gemicioglu, Sanja Popović Grle, Anneke Ten Brinke, Zsuzsanna Csoma, Iveta Kroiča, Piotr Kuna, Celeste Porsbjerg, Hilary Hodge, Florence Schleich, Sabina Skrgat, Ramesh J Kurukulaaratchy
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Abstract
Background: Multimorbidity refers to the presence of multiple coexisting conditions, but is often underappreciated in the context of severe asthma (SA) management. We sought to identify differences in approaches to multimorbidity management in SA, variability in access to multidisciplinary team (MDT) resources, and whether physician perspectives on multimorbidity differ between SA specialists and general respiratory physicians.
Methods: The Severe Heterogeneous Asthma Registry, Patient-centred (SHARP) Clinical Research Collaboration circulated an online physician survey via European national respiratory societies to assess 1) available resources to address multimorbidity and 2) physician perspectives on multimorbidity in SA.
Results: 495 responses from 25 European countries included 48% SA specialists and 52% general respiratory physicians. SA specialists had more experience with SA patients (20% were seeing >60 patients per month) compared to general respiratory physicians. SA specialists had greater access to multidisciplinary care - including better access to MDTs, allied health professionals and referrals to external specialists, and therefore more routinely assessed comorbidities and considered them greater influences on their practice. They also considered multimorbidity to a greater degree and rated its impact on their patients' asthma outcomes (and general health outcomes) as more substantial.
Conclusions: Alongside more experience of treating SA, SA specialists have increased awareness of multimorbidity and better resources to manage it. However, access to MDTs remains a significant gap for both SA specialists and general respiratory physicians. Furthermore, both groups identified a high need for further education and training about multimorbidity. These findings highlight key areas for improvement in clinical practice, resources and training.
期刊介绍：
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.
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